Tuesday, August 4, 2009

MY Vagina Monologue

I'm in a bad mood, so be prepared for a snarky post.

I had my first prenatal appointment with my new OB/GYN today. I decided to go with someone new, even though I used to love the doctor that I've used before, but after the second miscarriage, I didn't feel like she was answering my questions...or returning my phone calls. When I saw my PCP last week, I told her that I needed someone that would really hold my hand this time around, because I was going to be a basket case. So, she suggested this new doc. Yesterday, I stopped by my old doctor's office to get copies of my genetic testing results after the D&C, so that the new doc could have this info, at my PCP's suggestion.

Roy drove me and I spent a lot of time filling out paperwork, of course. They actually had this medical history form that is one of those fill-in-the-dots, machine-read forms. It took me back to grade school, when we had to do those state tests. Use only a number 2 pencil and fill in the entire circle... For "occupation", I listed "stay-at-home mom", much to my delight, and Roy's chagrin. He insisted that it doesn't count as a job. To which I replied, "I'm the CEO of this household!" (That's from "One Fine Day".) He fired back, "I'm the CEO, the COO and the CFO. This is the corporation of Roy in the city of Andreas!" Oh, he's funny.

Got weighed (146, yeah, I don't care who knows. Just let me say--4 pregnancies in 4 years!! Cut me some slack! ;), gave a urine specimen and then met my new doctor, who is very nice. I brought her the test results and she was flipping through them while we talked. My old doctor had told us that everything had appeared normal except that there was some gene that I have that could cause heart disease when I'm older. She said that the results did not indicate any problems that led to the miscarriages.

Well, new doctor is reading the same results and gets to that portion. The gene is called Methylenetetrahydrofolate reductase. Roy joked, "Well, there's the problem. You've been on meth!" The gene is shortened to MTHFR. You can guess what nickname he gave it. (He tries to joke a lot to keep me from crying.)

She tries to explain all this scientific crap about this gene and my eyes gloss over and I hear Charlie Brown's teacher going, "Wah wah wah, wah wah wah wah." But, the gist is that this gene can cause clotting, which we know very well is one of the possible causes of miscarriages. I was told specifically by my previous doctor that I did NOT have any blood clotting issues, so now I'm mad.

My mother had repeat miscarriages and a stroke. Since both can be caused by blood clotting and I may have a gene that causes blood clotting, this seems like a real red flag to me. My old doctor knew all of this and yet didn't mention it. I'm looking at the test results and it actually says, "Consider additional testing..." and "Consider genetic consultation and counseling of potentially affected family members..."

New doc says that given this gene and the fact that pregnancy increases your likelihood of getting blood clots anyway, I need to be sure to take necessary precautions on trips, like stopping every hour to walk around. So, turns out that I made a good decision when I stayed home this past weekend while Roy drove the 12 hours to Detroit. Who knew? Oh, my old doctor knew, but I didn't.

So, new doctor tells me to continue taking the progesterone supplement that I'm on and to add a baby aspirin every day to thin my blood. She says that this same gene may lead to a folic acid deficiency. Folic acid, as we know, is very important in the early weeks of pregnancy, which is why we take prenatal vitamins. She says I should stop taking the prenatal vitamin and start taking straight folate vitamins instead. She also says she will make me an appointment to see a perinatologist, which is someone who specializes in high-risk pregnancies. They will give me more information on the problems this gene may cause.

So, my head is spinning with all this new information that I should have gotten from my old doctor. Then, new doc says that she wants me to go have a sonogram done today, just to see how things are going. She warns that this early, there may not be much to see, probably just a gestational sac, but I already know that. She gives me an exam and warns repeatedly that the speculum may cause a little bleeding and not to be concerned. She obviously knows that having two miscarriages means that I'm watching very carefully for any spotting and will FLIP OUT if I have some. She even goes so far as to tell me that even though sex is not dangerous to the fetus, which we know, that I should probably just go ahead and abstain through the first trimester since that can cause bleeding too, and we don't want to freak me out. Roy nods with too much enthusiasm in the corner because he doesn't want to be responsible for causing a major meltdown. Was that too much information? You should probably stop reading now, 'cause it just keeps coming.

She said that everything looked normal and sent me off to have a gallon of blood drawn for tests. But not before assuring me that this pregnancy would go just fine. I know they think I want to hear that, but I know that they can't guarantee it and I wish they just wouldn't say it at all. I'd rather hear, "Well, we're sure going to do our best to help you get through this." Or something to that effect. I want the truth. I can handle the truth.

Got lots of blood taken from a very good phlebotomist. I hardly even noticed. Then, we went to check out. Doctor said to go ahead and schedule a sonogram for 2 weeks away and 4 weeks away, along with my next appointment. While we're there, the lovely receptionist asked if we wanted to go ahead and schedule future appointments. So, we scheduled our monthly appointments for the rest of the year. She would have kept going if I'd let her. I assured her that December was enough for me. I'm thinking to myself, these are just going to be more appointments that I have to cancel if something goes wrong. Yep. Debbie Downer right here.

Then, we pay a visit to the money lady, who tells us how much our care is going to cost. At least, I think that's what she said. She was incredibly old and I couldn't make out much of what she said, very softly and very slowly, but I nodded after I asked her to repeat herself a couple of times, because it seemed like the right thing to do. She seemed very nice, but again, she could have been cursing me, but she did it with a Grandma's smile on her face. Roy seemed to speak her language and they had a few laughs while I looked at the numbers. I wanted to ask, so how much do we pay if this all goes south in the next couple of weeks? Where is that paperwork? Oh, and since I'm using a new doctor, in a new group, I have to deliver at a different hospital and my pediatrician doesn't have rights there. So, some stranger would be seeing the baby whilst in the hospital. Awesome.

And then we rushed across town to make the sonogram appointment at their other location, since this one was booked. All of this is during the lunch hour, two hours after we arrived, after I've had a ton of blood drawn. I guess I should be thankful that the doctor and her support staff was willing to answer all my questions and spend as much time with me as necessary, but I didn't feel like looking at it that way right then. I only cried about 3 times during the visit. It is all just so stressful and I hate the waiting and the worry and I just feel like I've been at this point so often and it just seems hopeless. It totally freaks Roy out. Sorry about that, Sweetie.

Gentlemen, this is probably where you need to stop reading, if you haven't already. I wish there was a way to make sure only chicks could read your blog. Maybe a personality test beforehand? Would you rather be watching: A-"Terminator" or B-"When Harry Met Sally"? Only answer B will allow you to enter the site... Anyway...

Having had many early pregnancy sonograms, I asked the technician if I should empty my bladder, but she said that she would try to ultrasound on my stomach first. It didn't work, of course because it is so early in the pregnancy, so she had to use the vaginal stick-thing. Even though I knew her answer, I asked her anyway if this was safe. "Of course it is," she says. "But it may cause spotting," I say. "No, it shouldn't," she says, somewhat surprised. So, let me get this right...doc's speculum and sex may cause bleeding, but this big dildo-shaped sonogram thing won't? Doesn't make much sense to me. I just want to know what to expect, alright? If I go home and I'm bleeding, I want to know why because it is frickin' scary to see.

So, she gets started and quickly tells me that I have a tilted uterus. I kind of remember hearing my old doc say that when I was pregnant with Anna, but it "righted" itself during the course of the pregnancy and I hadn't heard about it since. Even with all the sonograms I've had since then, and there have been plenty, no one had mentioned it again until now. I guess that explains why the traditional ultrasound way doesn't tend to work on me.

She's looking around and suddenly says, "So, you had a positive home pregnancy test?" And I say, "No, I had a positive test at a doctor's appointment." "Here?" she says. "No, at my PCP," I say. "Well, the reason I ask," she says, "Is because I'm not finding anything in your uterus." "Oh, swell," I say.

I'll spare you the rest of the dialogue. She moved that thing around every which way and then some ways that aren't even possible and MY GOD was that uncomfortable. Ladies, the feeling of a pap smear--ten times over. It just wouldn't end. She didn't want to give up and I appreciate that, but at one point, I had to ask, "Is there anything I can do to help?" I mean, she was in there longer than it is EVER necessary for ANYTHING to be in a vagina and that is just a plain and simple fact. And I can't even remember her name.

Finally, she repeated that she didn't find anything in the uterus. She had then looked to see if I had an ectopic pregnancy, but didn't find anything in the fallopian tubes or the ovaries. Apparently, my ovaries were lying low or something, which made them harder to look at. She said that there was a lining in the uterus, which either means a pregnancy or Aunt Flo's getting ready to visit.

We got in the car and not even 2 minutes had passed before I got a call from the actual doctor herself. She said that the lining was thin, which, she was sorry to say, could indicate a false positive on the pregnancy test. I told her that with all the symptoms I had, I was pretty sure that was not the case. She said, then, that it just could be really early in the pregnancy. They determine due date by LMP until you have a really good sonogram, so it could be that I'm only a few weeks along instead of the 5.5 that they calculated.

The blood tests that I took today will give them a hormone level that should indicate the age of the pregnancy. I've done this enough times now that I knew the test would then have to be repeated in 2 days so they can compare HCG levels to determine if the pregnancy is "viable." God, I hate that word. So, I should get results on Thursday that will tell us something.

I actually expected bad news on this visit, because I'm just getting used to it, but Roy was pretty upset. He wants to be able to enjoy this pregnancy, understandably. "Why can't we ever get plain, old good news?!" he lamented. I hear ya, Buddy.